Have you noticed that December 31st seems to come around sooner and sooner with each passing year? As the New Year approaches it’s a tradition for many of us to make a personal resolution or two, and these often have something to do with improving our health. If this year your resolution once again involves weight loss I have some sound advice - Get help.

For many people weight control is just a matter of eating smarter and getting a little exercise, but for those who need to lose more than 50 or 60 pounds such efforts often seem futile. The fact is the more weight you need to lose the more difficult it is. Whenever you go on a diet your metabolism slows down to compensate for the lower calorie intake. You lose 5 pounds and gain 10. The effects of “Yoyo dieting” make weight loss increasingly more difficult with each attempt.  The only way to increase your metabolism and the number of calories you burn is through regular exercise. Sounds easy enough, but when you factor in the pain of hauling those extra pounds onto the treadmill everyday, combined with a busy work schedule, exercise becomes something you’ll get around to, eventually.

So what’s the answer? First, we must approach obesity like the disease it is. People who have a serious weight problem frequently have associated health problems like diabetes, high blood pressure, high cholesterol, sleep apnea, acid reflux, arthritis and many others. Interestingly, most overweight people are on several medications to control these “co-morbidities” while the underlying problem goes untreated.

The National Institutes of Health produced a comprehensive “White Paper” on the subject of obesity nearly 20 years ago, just as this epidemic was emerging. They appropriately pointed out the futility of trying to deal with significant obesity using diet and exercise alone. Statistics suggest that fewer than 5% of people who are 100 pounds or more over weight are able to lose their excess weight on their own and keep it off. These facts have given rise to a growing trend in weight control, namely bariatric surgery. Over the last 15 to 20 years the idea of surgery to assist with weight loss has become increasingly accepted and many procedures have evolved that can provide safe and effective solutions. However, weight loss surgery must be seen for what it is, a tool to help patients develop an overall healthier lifestyle.

Surgery is typically thought of as the last resort for treating any medical problem, but once the decision is made to undergo an operation our expectations are that a successful operation will “cure” the problem. While this is certainly true for appendicitis, a sick gallbladder or a fractured hip, obesity is not like most surgical problems. The operation doesn’t cure the patient. Undergoing a weight loss procedure is more like getting a prescription that you have to take everyday. These procedures can restrict the amount of food you can eat, but they don’t control what you choose to put in your mouth. If you drink milkshakes or eat high calorie foods like chocolate, or drink two or three glasses of wine or a couple of margaritas everyday, you simply won’t lose weight no matter what operation you’ve had. Success requires commitment and discipline as well as some common sense.

The Gastric Sleeve procedure has become very popular in the last few years largely because it significantly reduces hunger, making it much easier to avoid the temptation to overindulge. But following this procedure most patients still need guidance, both from a trained dietitian to ensure they maintain proper nutrition, and some type of support program to keep them focused on attaining their goals.

For those who have already had weight loss surgery and either failed to lose weight or lost it only to gain it back, there is still hope. Many so-called “surgical failures” may still achieve the success they originally expected. Sometimes the answer involves more surgery, but sometimes it’s just a matter of getting the proper support. If that’s you, don’t give in to the temptation to give up. Perhaps your resolution for 2011 should be “If at first you don’t succeed, get another opinion.”